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ObjectiveThe potential influence of hypothyroidism on breast cancer remains incompletely understood. The objective of this study was to investigate the relationship between serum thyrotropin (thyroid-stimulating hormone, TSH) concentration and markers of aggressive breast cancer biology as defined by receptor expression profile, tumor grade, and American Joint Committee on Cancer (AJCC) stage characteristics.MethodsThis was a retrospective cohort study of patients from 2002 to 2014. All breast cancer patients who had complete receptor (estrogen receptor, ER; progesterone receptor, PR; and human epidermal growth factor receptor 2, Her2/neu) and prediagnosis serum TSH data (n = 437) were included. All patients had 1 of 6 receptor profiles: ER+ PR+ Her2/neu-, ER+ PR- Her2/neu-, ER+ PR+ Her2/neu+, ER+ PR- Her2/neu+, ER- PR- Her2/neu+, or ER- PR- Her2/neu-. Log-transformed serum TSH concentrations were analyzed using multinomial and logistic regressions to identify potential relationships with markers of breast cancer aggressiveness.ResultsIncreasing serum TSH concentration was associated with a lower probability of having the receptor expression profile ER+ PR+ Her2/neu+ compared to patients with the ER+ PR+ Her2/neu- profile (odds ratio [OR] = 0.52, P = .0045). No significant associations between other receptor expression profiles and serum TSH concentration were found. All time-weighted and unweighted median serum TSH concentrations were within normal limits. No significant associations between serum TSH concentration and tumor grade, overall AJCC stage, tumor size (T), lymph node positivity (N), or presence of metastasis (M) were observed.ConclusionsSerum TSH was not associated with markers of breast cancer aggressiveness in our cohort.

Background and Purpose: Physical therapists (PTs) require specialized education and training to increase the capacity and competence of the dementia care workforce. Four areas of critical dementia workforce education and training gaps that apply to the physical therapy profession have been identified, including recruitment/retention, financing and cost of training, interprofessional education, and translation/implementation of effective dementia care. A critical step in developing effective training programs and educational curricula is to understand PTs' and PT students' experiences and views on working with people with dementia (PwD). Therefore, the purpose of this scoping review was to examine the extent and types of evidence that explore the experiences and views of PTs and PT students on the provision of physical therapy services to PwD. Methods: The Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, ERIC, PEDro, Web of Science, and Medline databases and sources of gray literature were searched for sources of evidence that met the inclusion criteria of the review protocol. The literature was mapped according to author, participant role, setting, publication type, study design, study aim, key findings, and dementia workforce training gaps addressed. Results and Discussion: A total of 552 sources of evidence were screened for eligibility, and 16 studies were selected for inclusion. Twelve studies included PTs as participants, and 5 included PT students. Included sources explored PTs' experiences, behaviors, knowledge, attitudes, and confidence in working with PwD and the influence of educational, organizational, and other factors on these domains. Challenges to and strategies for delivering effective care to PwD were examined in multiple sources. The 4 areas of critical dementia workforce education and training gaps were each addressed by at least 1 of the included studies. Conclusions: The current body of literature identifies several gaps in both research and education that need to be addressed before our profession is truly prepared to effectively manage this challenging population of patients with specialized needs. [ABSTRACT FROM AUTHOR]

The NIH Toolbox® was developed to assess functions among motor, sensory, emotional, and cognitive domains. The motor domain of the NIH Toolbox® includes an assessment for standing balance. Studies have validated early versions of the balance assessment for ages 3 through 85; however, no studies have examined the reliability and validity in its current version (using iPod Touch) against established balance measurements such as the Biodex SD modified clinical test of sensory integration of balance (m-CTSIB). Ninety-three community dwelling older adults (38 males 55 females) ≥60 years old (SD 74 ± 6). One-day assessment using the NIH Toolbox® and the Biodex SD m-CTSIB. Intraclass correlation coefficients (ICC3,1) were used to measure the test–retest reliability, and Pearson's product correlation examined criterion validity. The overall composite of the Biodex SD m-CTSIB and NIH Toolbox® showed moderate test-retest reliability (ICC3,1 = 0.71, MDC = 1.21) (ICC3,1 = 0.84, MDC = 0.65,) respectively. The NIH Toolbox® Theta Score and Biodex overall Sway Index (SI) shows acceptable reliability criterion validity (r = 0.52) indicating moderate overlap in constructs. The NIH Toolbox®balance assessment demonstrates acceptable criterion validity compared to the Biodex SD m-CTSIB. The NIH Toolbox® is a valid, reliable, and accessible device; therefore, the NIH Toolbox® should be considered for use in clinical evaluations. [ABSTRACT FROM AUTHOR]

This qualitative study explores the barriers to food security for vulnerable women from the perspective of charity managers within the Australian Capital Territory (ACT) Region. Interviews were conducted with six charity managers. Analysis of charity's perspectives identified nine themes across two overarching areas: barriers to charity providing food security services (charity accessibility, inter-charity support and charity reliance on donations) and barriers to women attaining food security (income, accommodation type, transport, women's attitudes and beliefs, stigma/trust and food literacy). Understanding the barriers to women's food security is essential in addressing the underlying social and economic issues creating food insecurity. [ABSTRACT FROM AUTHOR]

This study aims to examine group differences in performance and self-report measures distinguishing non-, single, and recurrent fallers. Fifty-seven community-dwelling older adults completed cognitive and functional assessments and reported number of falls over 12 months. A one-way analysis of variance (ANOVA) examined differences between non-, single, and recurrent fallers. Significant group differences were found on fast and comfortable gait speed (p <.01 and p <.01, respectively), Falls Efficacy Scale-International (FES-I) (p =.04), 30-Second Chair Stand (30-SCS) (p <.01), and Mini Mental State Examination (MMSE) (p <.01). An analysis of covariance (ANCOVA) was used to control for MMSE after which the previous outcome measures no longer displayed significance. Group differences exist between fallers; further, single fallers may experience a fall differently than other fallers. This sample consisted of healthy older adults yet cognition still played a role, demonstrating that the link between cognition and fall risk is yet to be fully understood. [ABSTRACT FROM AUTHOR]

Few investigations have examined dementia training programs for rehabilitation professionals. To address this, the L everaging E xisting A bilities in D ementia (LEAD) program was developed and examined with a pilot study. LEAD addressed dementia knowledge; the Strength-Based Approach; strategies for communication, recognizing behaviors, and learning techniques; and documentation. Participants completed pre-program, post-program, and three-month follow-up questionnaires assessing confidence, practice patterns, and dementia knowledge. Confidence and use of treatment strategies increased through the three-month follow-up and dementia knowledge significantly increased following training. LEAD positively impacted rehabilitation professionals' knowledge, confidence, and use of evidence-based treatment strategies. Implications of LEAD and future research are discussed. [ABSTRACT FROM AUTHOR]

Limited evidence exists regarding exercise interventions with individuals with dementia, which is often due to heterogeneity of methodology and outcomes being assessed. This led to the development and evaluation of a moderate-intensity home-based functional exercise program guided by theories from exercise science and the Strength-Based Approach. Data indicated excellent treatment adherence (99.04%) along with high levels of acceptability and feasibility in this sample (age 76.63 years (9.84); Mini Mental State Exam 18.87 (6.40)). This article informs future practice by highlighting the merits of a Strength-Based Approach in research examining exercise and physical rehabilitation to improve adherence and compliance with individuals with dementia. [ABSTRACT FROM AUTHOR]

Reducing Disability in Alzheimer’s Disease (RDAD) is an evidenced-based intervention for individuals with dementia and their caregivers aimed at reducing the psychosocial strain of the caregiver and improving functional ability of the individual with dementia. Overall efficacy, acceptability, and feasibility outcomes have been published regarding RDAD; however, no specific outcome information has been published on the objective physical performance measures (PPM) of gait speed, functional reach, and balance. Data from the Replication of RDAD (n = 508) was utilized to test the hypothesis that each PPM would show change for participants who completed the program. No significant changes were identified in 3 PPM: gait speed (t = .24, P =.81), balance (t = .23, P = .82), and functional reach (t = −.55, P = .58). To strengthen the research about exercise interventions for individuals with dementia, discussion and interpretation of nonfindings is important for improving intervention designs and methodologies. In the case of RDAD, the intervention protocol may require a sufficient dosage of exercise with respect to fundamental exercise science principles, or there may be misalignment between the intervention and outcome measures. [ABSTRACT FROM AUTHOR]